Individual provider Active NPI

Jeffrey Alan Hodd, D.D.S.

  • Prosthodontics
  • Fort Jackson, SC
National Provider Identifier
1184735839
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
10754 Issued in MN
Practice address
4323 Hill Street
USA Dentac
Ft Jackson, SC 29207-6022
Phone
(803) 751-6213
Fax
(803) 751-6886
NPI assigned
Aug 31, 2006
Last updated
Jun 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10754 MN
Prosthodontics 1223P0700X 10754 MN Primary

Addresses

Primary practice location

4323 Hill Street
USA Dentac
Ft Jackson, SC 29207-6022

Mailing address

4323 Hill Street
USA Dentac
Ft Jackson, SC 29207-6022
Phone (803) 751-6213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10754MNMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1184735839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 HILL STREET",
            "address_2": "USA DENTAC",
            "city": "FT JACKSON",
            "state": "SC",
            "postal_code": "292076022",
            "telephone_number": "803-751-6213",
            "fax_number": "803-751-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 HILL STREET",
            "address_2": "USA DENTAC",
            "city": "FT JACKSON",
            "state": "SC",
            "postal_code": "292076022",
            "telephone_number": "803-751-6213",
            "fax_number": "803-751-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODD",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "10754",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "10754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Jackson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.